A/HRC/14/18 14. With regard to the visit to the United States, Ms. Najcevska stated that the report would be finalized soon. She noted that there were many programmes and initiatives for people of African descent. However, there were also areas where challenges still needed to be addressed, including the existing vicious circle of poverty and lack of access to education and employment opportunities for people of African descent. The Working Group applauded advances with regard to direct discrimination, but expressed concern about existing structural discrimination. A. 1. Thematic discussion under agenda item 5 on structural discrimination against people of African descent Access to health 15. A presentation was made by Gustavo Makanaky, Director of International and Interinstitutional Studies at the Technological University of Choco, Colombia. The panellist reviewed the issue of structural discrimination against people of African descent in access to health. 16. The panellist noted that the United Nations played an important role with regard to monitoring and follow-up. Qualitative and quantitative studies by international organizations in specific areas such as health, employment and others were needed, for example by the World Health Organization (WHO)/Pan American Health Organization (PAHO), or the International Labour Organization (ILO). It was noted that sharing examples of positive measures in different areas would be useful. Health insurance companies and their treatment of different races should also be analysed in order to address structural discrimination. 17. The panellist pointed out that indicators should be adopted that give visibility to issues related to discrimination, thereby triggering real change. Effective implementation of rules and legislation was essential in order to improve results. 18. An observer suggested that the Working Group also consider the issue of health in the framework of the Millennium Development Goals. The vulnerability of unemployed people and their respective lack of insurance had a detrimental impact on their health. The observer invited the Working Group to discuss how to take issues to the Human Rights Council, emphasizing that it was essential that its recommendations were implemented. 19. Another observer pointed out that there was not enough information with regard to the structural causes of discrimination in health. Causes should be analysed first in order to look for solutions. The observer suggested that organizations such as WHO/PAHO, the United Nations Educational, Scientific and Cultural Organization (UNESCO) and ILO be formally invited to contribute to the work of the experts or that they send written statements on questions raised by the Working Group. 20. An observer pointed out that due attention should be paid to the issue of mental health. 2. Access to education 21. Ms. Sahli noted that people of African descent had limited access to education. Their geographic location — residing in developing or developed countries, poor urban areas or rural areas — affected access to education. That group faced structural poverty resulting in exclusion from education. Children from early childhood were affected by malnutrition resulting in deteriorating health, which also affected access to education. The expert pointed out that very often children left school after three years due to poverty and health problems, without acquiring basic skills — less than 50 per cent of students in the first year 5